scholarly journals Caloric Intake in Renal Patients: Repercussions on Mineral Metabolism

Nutrients ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 18
Author(s):  
Angela Vidal ◽  
Rafael Ríos ◽  
Carmen Pineda ◽  
Ignacio López ◽  
Ana I. Raya ◽  
...  
Keyword(s):  
Bone Mass ◽  
Current Knowledge ◽  
Mineral Metabolism ◽  
Fibroblast Growth Factor 23 ◽  
Plasma Concentrations ◽  
Caloric Intake ◽  
Calorie Intake ◽  
Caloric Content ◽  
Major Interest ◽  
Renal Patient

The aim of this paper is to review current knowledge about how calorie intake influences mineral metabolism focussing on four aspects of major interest for the renal patient: (a) phosphate (P) handling, (b) fibroblast growth factor 23 (FGF23) and calcitriol synthesis and secretion, (c) metabolic bone disease, and (d) vascular calcification (VC). Caloric intake has been shown to modulate P balance in experimental models: high caloric intake promotes P retention, while caloric restriction decreases plasma P concentrations. Synthesis and secretion of the phosphaturic hormone FGF23 is directly influenced by energy intake; a direct correlation between caloric intake and FGF23 plasma concentrations has been shown in animals and humans. Moreover, in vitro, energy availability has been demonstrated to regulate FGF23 synthesis through mechanisms in which the molecular target of rapamycin (mTOR) signalling pathway is involved. Plasma calcitriol concentrations are inversely proportional to caloric intake due to modulation by FGF23 of the enzymes implicated in vitamin D metabolism. The effect of caloric intake on bone is controversial. High caloric intake has been reported to increase bone mass, but the associated changes in adipokines and cytokines may as well be deleterious for bone. Low caloric intake tends to reduce bone mass but also may provide indirect (through modulation of inflammation and insulin regulation) beneficial effects on bone. Finally, while VC has been shown to be exacerbated by diets with high caloric content, the opposite has not been demonstrated with low calorie intake. In conclusion, although prospective studies in humans are needed, when planning caloric intake for a renal patient, it is important to take into consideration the associated changes in mineral metabolism.

Do Youth Consume More Calories than they Expended in Youth Sports Leagues? An Observational Study of Physical Activity, Snacks, and Beverages

2020 ◽  
Vol 44 (2) ◽  
pp. 180-187
Author(s):  
Natalie Bennion ◽  
Lori Andersen Spruance ◽  
Jay E. Maddock
Keyword(s):  
Physical Activity ◽  
Energy Consumption ◽  
Youth Sports ◽  
Caloric Intake ◽  
Average Energy ◽  
Cross Sectional Study ◽  
Calorie Intake ◽  
Caloric Content ◽  
Separate Analysis ◽  
Cross Sectional

Objectives: Childhood obesity rates remain high. The youth sports environment is an opportunity to combat obesity. The purpose of this study was to determine the types of beverages/ snacks provided at youth sports and determine associations between energy consumption and expenditure. Methods: This cross-sectional study observed 4 different sports in a youth sports league (N = 189). The System for Observing Fitness Instruction Time (SOFIT) was used to quantify physical activity. Food environmental scans were used to quantify caloric intake. A t-test was conducted to examine differences between energy consumption and expenditure. We conducted a separate analysis for games that did not offer snacks/beverages. Results: The average energy expenditure was 170.3 calories per game; males were more physically active than females. The average caloric content was 213.3 calories for games that did not offer snacks/beverages and average sugar provided was 26.4 grams per game. The majority of sugar came from sugar-sweetened beverages. Conclusions: Calorie intake was higher than expenditure. Children were consuming more sugar in one game than daily recommendations. Youth sports would benefit from an intervention aimed at the food environment.

P0919CALORIC RESTRICTION DOES NOT PROTECT AGAINST THE DEVELOPMENT OF VASCULAR CALCIFICATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Rafael Ríos-Varo ◽  
Ángela Vidal ◽  
Ana Isabel Raya ◽  
Carmen Pineda ◽  
Ignacio López ◽  
...  
Keyword(s):  
Food Intake ◽  
Vascular Calcification ◽  
Control Diet ◽  
Plasma Concentrations ◽  
Caloric Intake ◽  
Metabolizable Energy ◽  
High Rate ◽  
Caloric Content ◽  
Ad Libitum ◽  
Group 1

Abstract Background and Aims Vascular calcification (VC) is an important contributor to the high rate of cardiovascular mortality associated to chronic kidney disease. The inability to eliminate phosphorus (P) and the subsequent P retention promotes CV. P metabolism and uremic VC are influenced by obesity and by the caloric content of the diet. Caloric restriction (CR) has been shown to have multiple beneficial effects on health, for example, CR has been reported to improve vascular health and retard vascular ageing. However, to our knowledge the effect of CR on the development of uremic VC has not been explored. We hypothesize that CR may be beneficial to prevent the development of uremic VCs. Thus, the objective of the present study was to determine if rats subjected to CR were protected against VC. Method 48 Wistar rats were divided in four groups. The control diet provided Metabolizable Energy = 3.528 kcal/g and contained 0.6% Calcium (Ca) and 0.6% P. Additional diets of identical composition to the control diet but containing varying levels of Ca and P: 0.9% Ca, 0.9% P; 0.6% Ca, 1.2% P; and 0.9% Ca, 1.8% P, were also used in the experiments. Rats in Group 1 and 3 were fed 15 g/day of the control diet. Rats in Group 2 and 4 were calorie restricted and fed 10 g/day of diet with Ca/P = 0.9%/0.9%. Thus the daily P intake should be identical in the four groups. Uremia was induced by 5/6 nephrectomy (Nx). After Nx rats in Group 1 and 2 were fed ad libitum a diet with 0.6% Ca and 1.2% P. While rats in Group 3 and 4 were fed ad libitum a diet with 0.9% Ca and 1.8% P. Rats were supplemented with calcitriol. At the end of the experiment, rats were sacrificed to obtain blood samples and tissue samples (thoracic and abdominal aortas). After blood collection, plasma was separated by centrifugation and stored at –20° C until assayed. Plasma creatinine, Ca and P were measured by spectrophotometry. Energy intake was calculated based on food intake. VC was studied by histology and by measuring the tissue Ca content. Values are expressed as mean ± standard error (SE), the difference between groups was assessed by ANOVA. Fisher LSD test was used as a post-hoc procedure. p<0.05 was considered significant. Results Before Nx, caloric intake was significantly lower in calorie restricted rats (35.4 ± 0.1 and 35.8 ± 0.1 kcal/day) than in rats eating normal calories (52.7 ± 0.1 and 52.8 ± 0.2 kcal/day); however, P intake was almost identical in the four groups and ranged between 89.8 and 91.6 mg/day. After Nx, rats in all groups reduced food intake and, consequently, caloric intake. Thus, although the P content of the diet was increased after Nx, daily P intake was not increased in Groups 1 and 2; however, P intake was significantly increased in Groups 3 and 4 (120.9 ± 4.6 and 122.2 ± 6.2 mg/day, respectively). In all groups, rats had high plasma concentrations of creatinine and P, and low plasma concentrations of Ca. Also, all rats had elevated Ca content in the aorta. No significant differences between the study groups were found in any of these parameters (Table 1). Von Kossa staining of the aortas showed abundant mineral deposition in the four groups. Conclusion This study shows that, contrary to what was expected, CR did not prevent or ameliorate uremic calcifications.

Effects of L-Carnitine on Mineral Metabolism in the Multicentre, Randomized, Double Blind, Placebo-Controlled CARNIDIAL Trial

2018 ◽  
Vol 48 (5) ◽  
pp. 349-356 ◽  
Author(s):  
Lucile Mercadal ◽  
Sophie Tezenas du Montcel ◽  
Michel B. Chonchol ◽  
Alain Debure ◽  
Hélène Depreneuf ◽  
...  
Keyword(s):  
Linear Models ◽  
Mineral Metabolism ◽  
Fibroblast Growth Factor 23 ◽  
Plasma Concentrations ◽  
Repeated Measurements ◽  
Intradialytic Hypotension ◽  
Carnitine Supplementation ◽  
Mixed Linear Models ◽  
Limit Of Quantification ◽  
Double Blind

Background: The use of L-carnitine has been proposed in haemodialysis (HD) when deficiency is present to improve anaemia resistant to erythropoietin stimulating agent, intradialytic hypotension or cardiac failure. We tested the effects of L-carnitine supplementation on parameters of chronic kidney disease-mineral bone disorder. Methods: CARNIDIAL was a randomized, double-blinded trial having included 92 incident HD subjects for a 1-year period to receive L-carnitine versus placebo. Determinant factors of C-terminal fibroblast growth factor 23 (cFGF23) and intact FGF23 were studied including Klotho level. The L-carnitine effect on mineral metabolism was analyzed between groups by mixed linear models for repeated measurements. Results: Klotho was below the lower limit of quantification (LLOQ) in 55% of the 163 samples. In multivariate analysis, cFGF23 was positively correlated with calcium and phosphate and was higher in subjects having Klotho > LLOQ. No correlation existed between Klotho and phosphate and phosphate was even higher in subjects having Klotho > LLOQ (p < 0.001). Both forms of FGF23 were not related to iron markers nor to IV iron dose. No L-carnitine effect was detected on parathyroid hormone (PTH) or FGF23 during the study period where PTH slightly decreased over time, whereas FGF23 increased. But calcium and phosphate increased more in the L-carnitine group. Conclusion: L-carnitine supplementation increased calcium and phosphate plasma concentrations with no detected downregulation effect on PTH and FGF23. (Clinical Trial 00322322, May 5, 2006).

scholarly journals Energy-Dense Diets and Mineral Metabolism in the Context of Chronic Kidney Disease–Metabolic Bone Disease (CKD-MBD)

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1840
Author(s):  
Mariano Rodriguez ◽  
Escolastico Aguilera-Tejero
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Weight Loss ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Current Knowledge ◽  
Mineral Metabolism ◽  
Fibroblast Growth Factor 23 ◽  
Metabolic Bone

The aim of this paper is to review current knowledge about the interactions of energy-dense diets and mineral metabolism in the context of chronic kidney disease–metabolic bone disease (CKD-MBD). Energy dense-diets promote obesity and type II diabetes, two well-known causes of CKD. Conversely, these diets may help to prevent weight loss, which is associated with increased mortality in advanced CKD patients. Recent evidence indicates that, in addition to its nephrotoxic potential, energy-dense food promotes changes in mineral metabolism that are clearly detrimental in the context of CKD-MBD, such as phosphorus (P) retention, increased concentrations of fibroblast growth factor 23, decreased levels of renal klotho, and reduction in circulating concentrations of calcitriol. Moreover, in uremic animals, a high fat diet induces oxidative stress that potentiates high P-induced vascular calcification, and these extraskeletal calcifications can be ameliorated by oral supplementation of vitamin E. In conclusion, although energy-dense foods may have a role in preventing undernutrition and weight loss in a small section of the CKD population, in general, they should be discouraged in patients with renal disease, due to their impact on P load and oxidative stress.

scholarly journals Bone and Mineral Metabolism Phenotypes in MEN1-Related and Sporadic Primary Hyperparathyroidism, before and after Parathyroidectomy

Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1895
Author(s):  
Francesca Marini ◽  
Francesca Giusti ◽  
Federica Cioppi ◽  
Davide Maraghelli ◽  
Tiziana Cavalli ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Bone Mass ◽  
Bone Metabolism ◽  
Mineral Metabolism ◽  
Parathyroid Tissue ◽  
Young Patients ◽  
Surgical Removal ◽  
Mineral Density ◽  
Bone Mass Loss ◽  
Before And After

Primary hyperparathyroidism (PHPT) is the most common endocrinopathy in multiple endocrine neoplasia type 1 (MEN1). Persistent levels of increased parathyroid hormone (PTH) result in a higher incidence of osteopenia and osteoporosis compared to the general population. Surgical removal of hyper-functioning parathyroid tissue is the therapy of choice. This retrospective study evaluated the effect of parathyroidectomy (PTX) on bone metabolism and bone mass in two series of patients with MEN1 PHPT and sporadic PHPT (sPHPT) by comparing bone metabolism-related biochemical markers and bone mineral density (BMD) before and after surgery. Our data confirmed, in a higher number of cases than in previously published studies, the efficacy of PTX, not only to rapidly restore normal levels of PTH and calcium, but also to normalize biochemical parameters of bone resorption and bone formation, and to improve spine and femur bone mass, in both MEN1 PHPT and sPHPT. Evaluation of single-patient BMD changes after surgery indicates an individual variable bone mass improvement in a great majority of MEN1 PHPT patients. In MEN1 patients, PTX is strongly suggested in the presence of increased PTH and hypercalcemia to prevent/reduce the early-onset bone mass loss and grant, in young patients, the achievement of the bone mass peak; routine monitoring of bone metabolism and bone mass should start from adolescence. Therapy with anti-fracture drugs is indicated in MEN1 patients with BMD lower than the age-matched normal values.

scholarly journals The Complexity of FGF23 Effects on Cardiomyocytes in Normal and Uremic Milieu

Cells ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 1266
Author(s):  
Andreja Figurek ◽  
Merita Rroji ◽  
Goce Spasovski
Keyword(s):  
Chronic Kidney Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Current Knowledge ◽  
Fibroblast Growth Factor 23 ◽  
Mechanisms Of Action ◽  
Fibroblast Growth ◽  
Normal Kidney ◽  
Future Perspectives ◽  
Therapeutic Possibilities

Fibroblast growth factor-23 (FGF23) appears to be one of the most promising biomarkers and predictors of cardiovascular risk in patients with heart disease and normal kidney function, but moreover in those with chronic kidney disease (CKD). This review summarizes the current knowledge of FGF23 mechanisms of action in the myocardium in the physiological and pathophysiological state of CKD, as well as its cross-talk to other important signaling pathways in cardiomyocytes. In this regard, current therapeutic possibilities and future perspectives are also discussed.

scholarly journals Today Prospects for Tissue Engineering Therapeutic Approach in Dentistry

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Maurizio Bossù ◽  
Andrea Pacifici ◽  
Daniele Carbone ◽  
Gianluca Tenore ◽  
Gaetano Ierardo ◽  
...  
Keyword(s):  
Tissue Engineering ◽  
Stem Cells ◽  
Current Knowledge ◽  
Dental Stem Cells ◽  
Therapeutic Tool ◽  
Exponential Increase ◽  
Major Interest ◽  
Adult Mesenchymal Stem Cells ◽  
Therapeutic Protocols ◽  
Near Future

In dental practice there is an increasing need for predictable therapeutic protocols able to regenerate tissues that, due to inflammatory or traumatic events, may suffer from loss of their function. One of the topics arising major interest in the research applied to regenerative medicine is represented by tissue engineering and, in particular, by stem cells. The study of stem cells in dentistry over the years has shown an exponential increase in literature. Adult mesenchymal stem cells have recently been isolated and characterized from tooth-related tissues and they might represent, in the near future, a new gold standard in the regeneration of all oral tissues. The aim of our review is to provide an overview on the topic reporting the current knowledge for each class of dental stem cells and to identify their potential clinical applications as therapeutic tool in various branches of dentistry.

Kidney tubule health, mineral metabolism, and adverse events in persons with CKD in SPRINT

2021 ◽  
Author(s):  
Simon B Ascher ◽  
Rebecca Scherzer ◽  
Michelle M Estrella ◽  
Jarett D Berry ◽  
James A de Lemos ◽  
...  
Keyword(s):  
Adverse Events ◽  
Proportional Hazards ◽  
Mineral Metabolism ◽  
Fibroblast Growth Factor 23 ◽  
Kidney Injury ◽  
Cox Proportional Hazards ◽  
Hypertension Treatment ◽  
Kidney Tubule ◽  
Monocyte Chemoattractant Protein 1 ◽  
Kidney Injury Molecule 1

Abstract Background Measures of kidney tubule health are risk markers for acute kidney injury (AKI) in persons with chronic kidney disease (CKD) during hypertension treatment, but their associations with other adverse events (AEs) are unknown. Methods Among 2,377 Systolic Blood Pressure Intervention Trial (SPRINT) participants with CKD, we measured at baseline eight urine biomarkers of kidney tubule health and two serum biomarkers of mineral metabolism pathways that act on the kidney tubules. Cox proportional hazards models were used to evaluate biomarker associations with risk of a composite of pre-specified serious AEs (hypotension, syncope, electrolyte abnormalities, AKI, bradycardia, and injurious falls) and outpatient AEs (hyperkalemia and hypokalemia). Results At baseline, the mean age was 73 ±9 years and mean eGFR was 46 ±11 ml/min/1.73m2. During a median follow-up of 3.8 years, 716 (30%) participants experienced the composite AE. Higher urine interleukin-18, kidney injury molecule-1, neutrophil gelatinase-associated lipocalin (NGAL), and monocyte chemoattractant protein-1 (MCP-1), lower urine uromodulin (UMOD), and higher serum fibroblast growth factor-23 were individually associated with higher risk of the composite AE outcome in multivariable-adjusted models including eGFR and albuminuria. When modeling biomarkers in combination, higher NGAL (HR: 1.08 per 2-fold higher biomarker level, 95% CI: 1.03, 1.13), higher MCP-1 (HR: 1.11, 95% CI: 1.03, 1.19), and lower UMOD (HR: 0.91, 95% CI: 0.85, 0.97) were each associated with higher composite AE risk. Biomarker associations did not vary by intervention arm (P &gt;0.10 for all interactions). Conclusions Among persons with CKD, several kidney tubule biomarkers are associated with higher risk of AEs during hypertension treatment, independent of eGFR and albuminuria.

Propranolol in Children: Safety-Toxicity

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 30-31
Author(s):  
Michael Artman ◽  
Mitch Grayson ◽  
Robert C. Boerth
Keyword(s):  
Heart Rate Response ◽  
Plasma Concentrations ◽  
Caloric Intake ◽  
High Plasma ◽  
Intravenous Glucose ◽  
First Case ◽  
Acute Ingestion ◽  
Pharmacologic Effect ◽  
Propranolol Therapy ◽  
Very High

Four hours after acute ingestion of 400 to 1,200 mg of propranolol by a healthy, 3-year-old boy, his plasma concentration of propranolol was 2,289 ng/ml. The only pharmacologic effect observed was a diminished heart rate response to crying and activity. In a second case, a 4-year-old boy on chronic propranolol therapy for renovascular hypertension had a hypoglycemic seizure when solid food was refused for three days because of an oral wound. The hypoglycemia was easily managed with intravenous glucose, and there were no sequelae. The first case alludes to the safety of propranolol in a healthy child even with very high plasma concentrations. The second case suggests the necessity of anticipating and avoiding hypoglycemia that can develop in children on chronic propranolol therapy when caloric intake is impaired.

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